Transportation Industry - Knowledge & Resource Center

GCat: Ops, Maintenance, Safety
MCat: Safety
Cat: WC Forms

Obtain access to workers compensation forms for those states who provide them on their websites. The majority can be downloaded.

67 Resources
14 Day Injury Report Form [pdf] [34242] ?

Example of a form to be completed when an injured employee has been off the job for 14 days due to the injury

AK-Alaska - Workers Compensation Forms [6243] ?

Download Alaska workers compensation forms, first report of injury and more

AL-Alabama Workers Compensation Form [pdf] [21735] ?

Download First Report of Injury

AR-Arkansas - Workers Compensation Forms [1568] ?

Nearly 20 different workers compensation forms for the state of Arkansas may be downloaded

AZ-Arizona - Workers Compensation Forms [10615] ?

Workers comp forms, self-insured forms, ADOSH forms and more

CA-California - Self-insured WC Forms [4957] ?

Download workers compensation forms for the state of California self-insureds

CA-California - WC Forms in Numerical Order [4950] ?

Download physician and employer first report of injury forms, etc for the state of California

CA-California - Workers Compensation Forms [4951] ?

Download WC forms for California

CA-California - Workers Compensation Forms [10303] ?

Download a set of WC forms for the state of California

CO-Colorado - Workers Compensation Forms [10982] ?

Access WC forms for the state of Colorado

CO-Colorado Questionable WC Claim Notice [pdf] [34241] ?

Example of an attachment to First Notice of Loss when employer doubts injury has occurred

CT-Connecticut - Workers Compensation Forms [3541] ?

Large number of forms from the Connecticut Workers Compensation Commission

DC-District of Columbia: Workers Compensation Forms [11036] ?

Download WC forms for public workers in the District of Columbia

FL-Florida - Workers Compensation Forms [4959] ?

Download the commonly used workers compensation forms for Florida

GA-Georgia - Workers Compensation Forms [6267] ?

Download a large number of workers compensation forms for the state of Georgia

GA-Georgia Subsequent Injury Trust Fund Claim Forms [20036] ?

Also provides statutory filing requirements

HI-Hawaii WC Forms [32892] ?

Download workers compensation forms for the State of Hawaii

IA-Iowa - Workers Compensation Forms [10091] ?

Workers comp forms for the state of Iowa

ID-Idaho - Workers Compensation Forms Used by the Industrial Commission [6251] ?

Download WC forms for the state of Idaho

IL-Illinois Industrial Commission Forms [10983] ?

Download WC forms for the state of Illinois

IN-Indiana - Workers Compensation Forms [6255] ?

Download WC forms for the state for Indiana

KS-Kansas - Workers Compensation Forms [3903] ?

Download a large number of WC forms for the state of Kansas

KS-Kansas Self Insurance Forms [11205] ?

Download Kansas WC self-insurance application forms - spreadsheets

KY-Kentucky - Workers Compensation Forms [4966] ?

Download forms used for workers compensation in Kentucky

LA-Louisiana - Workers Compensation Forms & Instructions [7972] ?

Download WC forms for the state of Louisiana

MA-Massachusetts - Workers Compensation Forms [6259] ?

Download WC forms for the state of Massachusetts

MD-Maryland - Workers Compensation Forms [13522] ?

Some forms available for downloading

ME-Maine - Workers Compensation Forms [6262] ?

Download selected WC forms for the state of Maine

MI-Michigan - Workers Compensation Forms [5788] ?

Download WC forms, including the Employers Basic Report of Injury

MN-Minnesota - Workers Compensation Forms [4169] ?

Download the Minnesota WC forms

MN-Minnesota Employee Information Sheet [15288] ?

Employers give this sheet to employee with 1st Report of Injury

MO-Missouri - Workers Compensation Forms [10080] ?

Download frequently used workers compensation forms

MS-Mississippi - Workers Compensation Commission Forms [11220] ?

Download forms currently in use by the Commission

MT-Montana - Workers Compensation Court Forms [10092] ?

Download legal forms for the Workers Compensation Court of Montana

MT-Montana Workers Compensation Forms [15306] ?

Download Montana WC forms

NC-North Carolina - Workers Compensation Forms [4986] ?

Download forms required for workers compensation in North Carolina

ND-North Dakota Workers Compensation Forms [15317] ?

WC related forms for North Dakota

NE-Nebraska: Workers Compensation Forms [3020] ?

Download forms related to workers compensation in Nebraska

NH-New Hampshire - Workers Compensation Forms [11234] ?

Download approximately 15 workers compensation forms for the state of New Hampshire

NJ-New Jersey - Workers Compensation Forms & Brochures [6286] ?

Download workers compensation forms for the state of New Jersey

NM-New Mexico - Workers Compensation Forms [6288] ?

Download workers compensation forms for the state of New Mexico

NV-Nevada - Workers Compensation Forms [6290] ?

Download workers compensation forms for Minnesota

NY-New York - Workers Compensation Forms [4979] ?

Download commonly used forms required for WC in the state of New York

NY-New York Independent Medical Examination (IME) Forms [15221] ?

Download IME forms for the state of New York

OH-Ohio - Workers Compensation Forms [4989] ?

Download Ohio's common BWC forms

OH-Ohio Industrial Commission Forms [659] ?

Download the forms for WC for the state of Ohio

OR-Oregon - Workers Compensation Forms [4984] ?

Download a very large number of workers compensation forms for Oregon

PA-Pennyslvania - Workers Compensation Forms [10984] ?

Access WC forms for the state of Pennyslvania

Return to Work - Employee Handout [pdf] [35794] ?

Example of a return to work policy to be given to employees

RI-Rhode Island - Workers Compensation Forms [16124] ?

Download WC forms for the State of Rhode Island

SC-South Carolina Workers Compensation Forms [23170] ?

Download a series of workers compensation forms for the state of South Carolina

SD-South Dakota - Workers Compensation Forms [13521] ?

Download WC forms including First Report of Injury for South Dakota

TN-Tennessee WC Forms [14401] ?

Download a series of workers compensation forms for the state of Tennessee

TX-Texas - WC Forms [4995] ?

List of workers compensation forms and brochures

US Division of Coal Mine Workers' Compensation Forms - Black Lung [29025] ?

OWCP forms for federal workers to apply for workers compensation benefits under Black Lung benefits

US Division of Energy Employees Occupational Illness Compensation Claims Forms [29026] ?

Claims forms for benefits under the Energy Employees Occupational Illness Compensation Program Act

US Division of Federal Employees Compensation Forms [29023] ?

OWCP forms for federal workers to apply for workers compensation benefits

US Division of Longshore and Harbor Workers' Compensation Forms [29024] ?

OWCP forms for federal workers to apply for workers compensation benefits under Longshore benefits

UT-Utah Workers Compensation Forms [23225] ?

Download a variety of WC forms for the State of Utah

VA-Virginia - Workers Compensation Commission Forms [13084] ?

Download WC forms for the state of Virginia - self-insurance forms, etc

VT-Vermont - Workers Compensation Forms [5001] ?

Download workers compensation forms

WA-Washington - Electronic Filing of Quarterly Reports [10093] ?

File industrial insurance quarterly reports on-line

WA-Washington - Workers Compensation Forms [3607] ?

Download state of Washington workers compensation forms

WA-Washington Board of Industrial Appeals WC Form [15266] ?

Information for the WC appeals process

WI-Wisconsin - Workers Compensation Forms [4803] ?

Access a variety of forms (e.g., first report of injury) related to workers compensation

WV-West Virginia - Workers Compensation Forms [4782] ?

The following forms are approved for use in West Virginia workers compensation claims

WY-Wyoming - Workers Compensation Forms [16123] ?

Download WC forms for the state of Wyoming


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Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.


- Cross References to other LAD Libraries (21)


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